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NPI Code Detail

MEDICARE: ALEXANDER CLIFFORD WADE MD

MEDICARE: ALEXANDER CLIFFORD WADE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianMD446851PA

General Provider Information

NPI Number : 1750423513
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDER CLIFFORD WADE MD
Provider Business Mailing Address
First Line : 4417 N 6TH ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19140-2319
Country : US
Telephone Number : 215-302-3600
Fax Number :
Provider Business Practice Location Address
First Line : 4417 N 6TH ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19140-2319
Country : US
Telephone Number : 215-302-3600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2007
Last Update Date : 03/24/2023

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